Breast Reconstruction After Breast Cancer
Breast cancer is one of the most widely seen cancers in the world. Losing breast due to cancer can affect women physically and psychologically. Recreating a breast tissue (reconstruction) provides a big change in a positive way in the patient’s self esteem and psychology. In this month’s issue, we would like to talk about breast reconstruction for women who had their breast tissue removed due to cancer.
In terms of timing, breast reconstruction can be performed in two different stages. It can be done either simultaneously with breast tissue removal, or later on after the breast tissue removal operation (mastectomy) . Those who have simultaneous mastectomy and breast reconstruction are usually early diagnosed patients. In this operation, general surgeon removes breast tissue and a plastic surgeon reconstructs the breast. If the cancer is advanced, breast reconstruction will have to be performed after 1 year mastectomy – as the patient is likely to have radiation therapy. Breast cancer treatment and reconstruction should be evaluated and planned with a group of experts of general surgery, oncology and plastic surgery. In this way the best treatment plan can be prepared for the patient.
There are a few methods in breast reconstruction. We can divide these into two main categories as “grafting” and “breast implants”. Grafting consists of utilizing natural body tissues, mainly fats, to inject back to the breast to give it a shape. In grafting, usually the first preference is extraction tissue from abdomen as it is soft, fatty and easily shaped tissue. Abdomen can be utilized in two manners: First is utilizing skin, fat and abdominal muscles. The second method is utilizing only abdominal skin and fat without the muscle tissue. Both methods have their own pros and cons. The first one relatively takes shorter time – however as abdominal muscles are used, it may lead hernia and it can not be performed for overweight patients. The second method where only the abdominal skin and fat are used has become more and more popular recently. As muscles are not intervened in this method, there is no risk of hernia. But it requires much more expertise in microsurgery and experience. Both procedures can leave scars, that resemble to cesarean delivery scar. In our clinic, the most preferred method is the second one, by utilizing our expertise in microsurgery.
For the patients that do not have enough fat and skin in abdomen, silicone implants can be a solution. In this method, usually a small amount of muscle tissue is extracted from the back of the patient and transferred into the breast, after that a silicone balloon is placed. This balloon is inflated with certain time intervals. Once it reaches its optimal size, the balloon is removed and the silicone implant is left inside the breast. This method takes shorter but it requires two sessions to complete.
Who can undergo this surgery?
Anyone in good health conditions can undergo this surgery. However, the risk of complications is higher in patients that smoke.
How long does it take?
It depends on the method used. For example, if the muscle tissue is extracted from the back and silicone implant is placed, it usually takes 4-5 hours. But when microsurgical methods are used, it can take up to 6-7 hours – if two breasts need to be reconstructed, it can even take 12 hours in total.
How is the healing process after the surgery?
Depending on the method used, patient may stand up and consume liquids on the same day. Surgical drains are removed in 3-4 days. It is recommended to wear compression corset for 2 months. In order to provide a complete symmetry of two breasts, smaller interventions may be needed in the future as areola re-shaping.
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